Low-cost alternative drugs help reduce high blood pressure

Amiloride and spironolactone are diuretics or ‘water pills’ that have been available for many years but no longer get much attention from prescribing physicians.

A study by Indiana University School of Medicine led by Dr Howard Pratt reviewed the affects of the two drugs in a group of 98 African-American patients with high blood pressure. This study population was chosen because a disproportionately high number of African-Americans experience elevated blood pressure.

A comparison was made between the affects of taking both drugs simultaneously or alone compared to placebo. All patients continued to take their standard blood pressure medication. Overall the blood pressure of the patients taking either amiloride or spironolactone individually or in combination dropped significantly. There were no side-effects.

The two drugs tested work by limiting the amount of sodium the kidneys reabsorb or take back into the body during the process of producing urine.

Unlike traditional diuretics amiloride and spironolactone inhibit the uptake of sodium in the late or downstream region of the kidneys. When used with other diuretics which act on the early region of the kidneys, the researchers say blood pressure can often be restored to normal levels.

Dr Pratt said that physicians with patients showing resistance to standard treatments tend to prescribe higher doses of the medicine already being used, or add in a new blood pressure drug that could be expensive and ineffective. Dr Pratt expects that this and additional studies will convince physicians to try the amiloride or spironolactone alternatives instead.

Uncontrolled blood pressure can lead to serious complications including heart attack, stroke, and kidney failure. According to some estimates, nearly one in three US adults has high blood pressure.